RESUMEN
OBJECTIVE: The purpose of this study is to investigate the prevalence of MRSA among people living with HIV/AIDS (PLHA) being monitored in a tertiary outpatient hospital in the state of Pernambuco, in the Brazilian Northeast. RESULTS: Staphylococcus aureus was isolated from a nasal swab and found in 31.4% of the individuals (95% CI 27.3-35.5), of whom 4.4% (95% CI 8.5-19.5) were MRSA, as confirmed by the presence of the mecA gene. For individuals whose S. aureus was recovered, the mean age was 41.5 years; 93.6% were on antiretroviral treatment. This group had CD4 cell counts > 200 (92%) and viral load ≤ 100 copies (79.1%). Use of antimicrobial agents in the past 12 months was found among 21% of the individuals, and 24.2% reported use of illicit drugs at lease once in their lifetime. Prevalence of nasal colonization by MSSA (26.7%) and MRSA (4.4%) was higher in comparison to other studies of this population; nevertheless, we were unable to establish factors associated with risk.
Asunto(s)
Infecciones por VIH/epidemiología , Staphylococcus aureus Resistente a Meticilina , Nariz/microbiología , Infecciones Estafilocócicas/epidemiología , Centros de Atención Terciaria/estadística & datos numéricos , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Adulto , Brasil/epidemiología , Comorbilidad , Estudios Transversales , Femenino , Humanos , Masculino , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Staphylococcus aureus Resistente a Meticilina/patogenicidad , Persona de Mediana Edad , Pacientes Ambulatorios/estadística & datos numéricos , Infecciones Estafilocócicas/microbiologíaRESUMEN
BACKGROUND: In Brazil, schistosomiasis is a parasitic disease of public health relevance, mainly in poor areas where Schistosoma mansoni is the only human species encountered and Biomphalaria straminea is one of the intermediate host snails. A nested-PCR based on a specific mitochondrial S. mansoni minisatellite DNA region has been successfully developed and applied as a reference method in Brazil for S. mansoni detection, mainly in host snails for epidemiological studies. The amplification efficiency of LAMP is known to be higher than PCR. The present work aimed to assess the utility of our previously described SmMIT-LAMP assay for S. mansoni detection in human stool and snail samples in a low-transmission area of schistosomiasis in the municipality of Umbuzeiro, Paraíba State, Northeast Region of Brazil. METHODOLOGY/PRINCIPAL FINDINGS: A total of 427 human stool samples were collected during June-July 2016 in the municipality of Umbuzeiro and an overall prevalence of 3.04% (13/427) resulted positive by duplicate Kato-Katz thick smear. A total of 1,175 snails identified as Biomphalaria straminea were collected from 14 breeding sites along the Paraíba riverbank and distributed in 46 pools. DNA from human stool samples and pooled snails was extracted using the phenol/chloroform method. When performing the SmMIT-LAMP assay a total of 49/162 (30.24%) stool samples resulted positive, including 12/13 (92.31%) that were Kato-Katz positive and 37/149 (24.83%) previously Kato-Katz negative. By nested-PCR, only 1/46 pooled DNA snail samples was positive. By SmMIT-LAMP assay, the same sample also resulted positive and an additional one was positive from a different breeding site. Data of human and snail surveys were used to build risk maps of schistosomiasis incidence using kernel density analysis. CONCLUSIONS/SIGNIFICANCE: This is the first study in which a LAMP assay was evaluated in both human stool and snail samples from a low-transmission schistosomiasis-endemic area. Our SmMIT-LAMP proved to be much more efficient in detection of S. mansoni in comparison to the 'gold standard' Kato-Katz method in human stool samples and the reference molecular nested-PCR in snails. The SmMIT-LAMP has demonstrated to be a useful molecular tool to identify potential foci of transmission in order to build risk maps of schistosomiasis.
Asunto(s)
Biomphalaria/parasitología , Técnicas de Amplificación de Ácido Nucleico , Schistosoma mansoni/aislamiento & purificación , Esquistosomiasis mansoni/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Animales , Brasil , ADN Protozoario/aislamiento & purificación , Vectores de Enfermedades , Heces/parasitología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Análisis Espacial , Adulto JovenRESUMEN
The availability of some sorts of biological samples which require noninvasive collection methods has led to an even greater interest in applying molecular biology on visceral leishmaniasis (VL) diagnosis, since these samples increase the safety and comfort of both patients and health professionals. In this context, this work aimed to evaluate the suitability of the urine as a specimen for Leishmania infantum kinetoplast DNA detection by real-time quantitative PCR (qPCR). Subsequent to the reproducibility analysis, the detection limit of the qPCR assay was set at 5fg (~0.025 parasites) per µL of urine. From the comparative analysis performed with a set of diagnostic criteria (serological and molecular reference tests), concordance value of 96.08% was obtained (VL-suspected and HIV/AIDS patients, n=51) (P>0.05). Kappa coefficient (95% CI) indicated a good agreement between the test and the set of diagnostic criteria (k=0.778±0.151). The detection of Leishmania DNA in urine by qPCR was possible in untreated individuals, and in those with or without suggestive renal impairment. Fast depletion of the parasite's DNA in urine after treatment (from one dose of meglumine antimoniate) was suggested by negative qPCR results, thus indicating it as a potential alternative specimen to follow up the efficacy of therapeutic approaches. Even when evaluated in a clinically heterogeneous set of patients, the urine showed good prospect as sample for VL diagnosis by qPCR, also indicating a good negative predictive value for untreated suspected patients.
Asunto(s)
ADN de Cinetoplasto/aislamiento & purificación , ADN de Cinetoplasto/orina , Leishmania infantum/genética , Leishmaniasis Visceral/diagnóstico , Leishmaniasis Visceral/orina , Técnicas de Diagnóstico Molecular/métodos , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Orina/parasitología , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Adolescente , Adulto , Anciano , Brasil , Niño , Creatinina/sangre , Creatinina/orina , ADN de Cinetoplasto/sangre , ADN de Cinetoplasto/genética , ADN Protozoario/sangre , ADN Protozoario/aislamiento & purificación , ADN Protozoario/orina , Femenino , VIH/patogenicidad , Humanos , Leishmania infantum/patogenicidad , Leishmaniasis Visceral/sangre , Leishmaniasis Visceral/parasitología , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Urea/sangre , Urea/orina , Adulto JovenRESUMEN
Healthcare professionals (HCPs) are liable to pathogenic microorganisms infection/colonization, which plays an important role as a potential source of transmission to patients, coworkers, relatives and communities. The present study evaluates the prevalence of Staphylococcus aureus colonization in HCPs who work at a reference hospital in Recife, PE, and the isolates profiles of susceptibility to antimicrobial drugs. A cross-sectional study was undertaken, and HCPs from operating rooms, intensive care units (ICUs), hemodialysis and nephrology units of the Clinical Hospital of Pernambuco were evaluated. S. aureus isolates were identified by standard methods recommended by CLSI and the susceptibility to methicillin and vancomycin was determined by the minimum inhibitory concentration technique (E-test). The prevalence of S aureus observed among HCPs was 25.7%. Among S. aureus strains isolates, the highest percentage of antibiotic resistance was observed in penicillin (91.4%), erythromycin (43.1%) and cefoxitin (17.2%). All of the strains were sensitive to vancomycin. Three S. aureus methicillin-resistant (MRSA) strains were identified, which were isolated from the nursing aides staff. The prevalence of MRSA found in the present study was lower than those reported elsewhere. These findings suggest that a continuous assessment should be performed for better understanding the dynamic
Infecção/colonização por microrganismos patogênicos em profissionais de saúde (PS) representa uma potencial fonte de transmissão para os pacientes, colegas de trabalho, familiares e comunidade. No presente estudo foi avaliada a prevalência da colonização por Staphylococcus aureus em PS de um hospital de referência do Recife, no período de março e julho de 2007, e o perfil de susceptibilidade das cepas isoladas às drogas antimicrobianas. Foi realizado um estudo transversal, no qual os PS de salas cirúrgicas, unidades de terapia intensiva (UTIs), hemodiálise e unidades de nefrologia foram avaliados. O isolamento e a identificação de S. aureus foram efetuados de acordo com as orientações do CLSI. O perfil de susceptibilidade da bactéria aos antimicrobianos meticilina e vancomicina foi determinado por meio de técnica de difusão em disco associada à técnica de concentração inibitória mínima (E-test). A prevalência de colonização por S. aureus entre os PS foi de 25,7%. Entre as cepas isoladas de S. aureus, os maiores percentuais de resistência foram observados frente à penicilina (91,4%), eritromicina (43,1%) e cefoxitina (17,2%). Todos os isolados foram sensíveis à vancomicina. Três cepas foram identificadas como resistentes à meticilina, as quais foram isoladas de auxiliares de enfermagem. Sugere-se que avaliações contínuas sejam realizadas para melhor compreensão da dinâmica de co